European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2013
Multicenter StudyAntiplatelet therapy at the time of coronary artery bypass grafting: a multicentre cohort study.
The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events. ⋯ Preoperative APT is associated with increased bleeding and greater transfusion requirements after CABG. Clopidogrel exposure is associated with greater reoperation rates and is an independent risk factor for severe postoperative bleeding.
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Eur J Cardiothorac Surg · Aug 2013
Is the new EuroSCORE II a better predictor for transapical aortic valve implantation?
Conventional surgical risk scores are used to identify suitable candidates for transapical aortic valve implantation (TA-AVI) at present. However, these scores do not consider multiple high-risk conditions, including porcelain aorta, mediastinal irradiation or frailty. The aim of this study was to compare the predictive ability of the new EuroSCORE II with the surgical risk scores currently in use. ⋯ In patients undergoing TA-AVI, the new EuroSCORE II correlates strongly with the logistic EuroSCORE, but is a poorer predictor of 30-day and in-hospital mortality than the STS score. A true transcatheter aortic valve implantation risk score would be desirable beyond the established scores.
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Eur J Cardiothorac Surg · Aug 2013
Omitting chest tube drainage after thoracoscopic major lung resection.
Absorbable mesh and fibrin glue applied to prevent alveolar air leakage contribute to reducing the length of chest tube drainage, length of hospitalization and the rate of pulmonary complications. This study investigated the feasibility of omitting chest tube drainage in selected patients undergoing thoracoscopic major lung resection. ⋯ The refined strategy for pneumostasis allowed the omission of chest tube drainage in the majority of patients undergoing thoracoscopic major lung resection without increasing the risk of adverse events, which may contribute to a fast-track surgery.
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Eur J Cardiothorac Surg · Aug 2013
Randomized Controlled TrialVideo-assisted vs open mediastinal lymphadenectomy for Stage I non-small-cell lung cancer: results of a prospective randomized trial.
Since the introduction of video-assisted lobectomy for non-small-cell lung cancer (NSCLC) into clinical practice, it has been discussed controversially whether mediastinal lymphadenectomy can be performed as effectively as an open procedure via thoracotomy. Therefore, we address this issue in a prospective randomized trial conducted in our institution. ⋯ Mediastinal lymph node dissection can be performed as effectively by the video-assisted approach as by the open thoracotomy approach. Furthermore, the video-assisted approach allows a better visualization of different lymph node zones.
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Eur J Cardiothorac Surg · Aug 2013
Disparity in right vs left ventricular recovery during follow-up after ventricular septal defect correction in children.
Long-term prognosis after ventricular septal defect (VSD) correction in childhood is excellent. Nevertheless, decreased biventricular systolic performance has been described immediately following VSD surgery in children. In an effort to better understand this decrease and its time-course, we characterized biventricular systolic performance following VSD closure in paediatric patients up to 20 months postoperatively. ⋯ Within the first year after VSD correction, LV systolic performance had normalized, while RV systolic performance remained significantly impaired up to 20 months after VSD closure. Both detrimental effects of open heart surgery with cardiopulmonary bypass and preoperative alterations may add to the observed postoperative impairment of specifically RV performance.